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Aspirin, Antihistamines: Kids Often Use OTC Drugs in Suicide Attempts

By Serena Gordon
HealthDay Reporter

MONDAY, Oct. 7, 2019 (HealthDay News) — More teens are attempting suicide by overdosing on drugs, and new research suggests they are often turning to over-the-counter (OTC) medications like ibuprofen and aspirin in their efforts.

Antidepressants, antipsychotics and antihistamines were also common choices, the researchers added.

“What we were seeing was youth increasing suicide attempts using medications readily available in the home,” said study author John Ackerman, suicide prevention coordinator at the Center for Suicide Prevention and Research at Nationwide Children’s Hospital in Columbus, Ohio.

“People think that youth are thinking deeply about which medicine to take, but when someone is in crisis, it’s what’s in the medicine cabinet. These drugs are having very serious medical outcomes for young people,” Ackerman added.

Girls were much more likely than boys to attempt suicide by what is known as “self-poisoning,” and suicide attempts by self-poisoning in children and teens were higher in rural communities. These types of suicide attempts occurred more often during the school year, the study found.

When people survive a self-poisoning suicide attempt, they may have heart problems or seizures afterwards. Ackerman said that the drugs may have an impact on brain function as well.

“This paper is a call to action for parents to increase their safe storage practices and talk to kids about their mental health concerns,” he added. “Ask your kids how they’re doing.”

Parents may think it’s impossible to keep kids away from all medicines. “But, if you’re adding barriers — like a lock box or safe, and counting medication — those seemingly simple tasks can help. They can be a bridge to a child or teen seeing other options,” Ackerman explained.

From 2000 to 2018, more than 1.6 million young people between the ages of 10 and 25 attempted suicide by self-poisoning. The rates of these suicide attempts in young people aged 10 to 18 started to increase in 2011, the study found.

Almost one-quarter of those attempts resulted in a serious medical outcome. The drugs most used in these attempts were OTC pain relievers, antidepressants, antihistamines and antipsychotics. Opioids were only involved in 7% of cases with a serious medical outcome.

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ADHD medications were more commonly used in the younger group — 10- to 15-year-olds.

Less densely-populated states were more likely to have reported cases ending in serious medical outcomes.

“Rural communities are more at risk. It might be social isolation, lack of access to mental health care and economic factors,” Ackerman suggested.

In kids 18 and younger, suicide attempts by self-poisoning occurred more during the school months of September through May. This pattern wasn’t seen in the 19- to 21-year-old age group. The 22- to 25-year-old group had an increase in the summer months.

“Younger people seem to be more vulnerable during the school year,” Ackerman said. Although the study didn’t look at causes behind the findings, he said that school stress, peer behaviors, bullying and social media likely play a role.

Daniel Reidenberg, executive director of Suicide Awareness Voices of Education, reviewed the study and said, “In an acute suicidal crisis, people turn to the quickest, most easily available means.”

He said there are usually signs before someone reaches a crisis level. “People might be struggling with sleep; their appetite might be off; they might talk about aches and have other complaints about physical problems. They don’t want to go to school. They don’t want to interact with their friends,” Reidenberg said.

Of even greater concern is when someone talks about being a burden or says they have no hope for the future. They might start to look for ways to die or talk about suicide.

Reidenberg said a huge red flag is if someone just can’t sleep for a few days. “Anxiety and agitation become worse as someone gets sicker. It’s very, very important that anyone who might be at risk of suicide be monitored for sleep. It can be hard to notice disrupted sleep patterns in teens, but if there’s one, two or three days without sleep, you need to have a conversation, and hopefully get some professional help.”

Reidenberg added that connections are crucial: “The more connections that people have, the better off they are. A sense of aloneness increases the sense of distress and the risk of suicide.”

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If you find your child has attempted self-poisoning, Ackerman said it’s important to get them to the ER immediately. The sooner they get help, the better the chances for a good outcome.

The findings were published Oct. 7 in Clinical Toxicology.

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Sources

SOURCES: John Ackerman, Ph.D., suicide prevention coordinator, Center for Suicide Prevention and Research, Nationwide Children’s Hospital, Columbus, Ohio; Daniel J. Reidenberg, Psy.D., executive director, Suicide Awareness Voices of Education, and managing director, National Council for Suicide Prevention, and general secretary, International Association for Suicide Prevention; Oct. 7, 2019,Clinical Toxicology

Copyright © 2013-2018 HealthDay. All rights reserved.

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Daily Low-Dose Aspirin May Help Some People

By Dennis Thompson
HealthDay Reporter

MONDAY, Sept. 16, 2019 (HealthDay News) — Debate over the benefits and drawbacks of daily low-dose aspirin has flared in recent years, with guidelines now generally urging against the regimen to prevent a first heart attack or stroke in healthy people.

But some people with good heart health still might benefit from taking daily low-dose aspirin, a new study from New Zealand argues.

About 2.5% of women and 12% of men would likely benefit from daily aspirin during a five-year period, based on an analysis of more than 245,000 heart-healthy New Zealand residents.

“In our study, we were able to predict for each individual, by taking into account their personal characteristics, their propensity to benefit from or be harmed by aspirin,” said lead researcher Vanessa Selak, an epidemiologist with the University of Auckland in New Zealand.

“Using this personalized approach enabled us to identify specific individuals who were likely to benefit from aspirin after weighing up aspirin’s effects on both cardiovascular events and serious bleeding,” Selak continued.

That would seem to contradict new guidelines issued earlier this year by the American Heart Association (AHA) and the American College of Cardiology (ACC).

The two groups concluded that for older adults with healthy hearts, the risk of bleeding that comes with aspirin therapy outweighs any heart benefit.

“We used to say aspirin generally yes, occasionally no. Now we say aspirin generally no, occasionally yes,” said Dr. Amit Khera, who served on the ACC/AHA committee that wrote the guidelines.

However, Khera feels this new study actually supports the new guidelines.

“This modeling exercise confirmed it’s a very small group of the population that potentially could be eligible for aspirin,” said Khera, a professor of cardiology with UT Southwestern Medical Center in Dallas.

These guidelines are not for people who’ve had an emergency regarding their heart health. Those people do derive overall benefit from aspirin, he said.

“If you’ve had a heart attack or stroke, continue to take your aspirin,” Khera said.

But clinical trial data that emerged in 2018 showed that daily aspirin taken by people in good heart health only reduces their risk of heart attack and stroke by 11%, but increases their risk of dangerous bleeding by 43%, he added.

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“I want to be clear that I’m not talking about nosebleeds,” Khera said. “I’m talking about needing a transfusion, being hospitalized, bleeding in the brain. Big stuff.”

To take a closer look at the potential benefits of aspirin, Selak and her colleagues studied hundreds of thousands of New Zealanders without heart disease who had their heart health risk calculated between 2012 and 2016.

The net effect of aspirin was calculated for each person by subtracting the number of heart emergencies the person was likely to have over five years from the number of major bleeds aspirin could cause.

After personalizing the risk-versus-benefit calculation, the researchers found that a select group of people would have a net benefit from aspirin if one heart health emergency that led to hospitalization or death was considered equal to one major bleed that led to hospitalization or death.

The percentages increased to 21% of women and 41% of men if a heart health emergency was considered equal to two major bleeds, the findings showed.

“This research suggests that decisions regarding the use of aspirin among people who have not already had a cardiovascular event should be made after undertaking a personalized prediction of cardiovascular benefits and bleeding harms from aspirin,” Selak said.

That’s already standard procedure under the U.S. guidelines, Khera said.

“No one is saying aspirin doesn’t help. It just doesn’t help as much as we used to think, and you have to appreciate the bleeding penalty,” Khera said. “Some people are more concerned about heart attack risk and are willing to pay the bleeding penalty, especially if they’ve never had any bleeding problems. It’s still OK for them to consider it.”

Both Selak and Khera recommended that people talk with their doctor about the risks and benefits before starting to take daily aspirin. Calculators are available that help physicians weigh your risk of heart attack and stroke against the risk of bleeding.

“In many ways, people think of aspirin as this benign thing because it’s been around for centuries. Anybody can get it over the counter,” Khera said. “But if you’re going to take it every day for the next couple of decades, there are definite penalties to it.”

The new study was published online Sept. 17 in the Annals of Internal Medicine.

WebMD News from HealthDay

Sources

SOURCES: Vanessa Selak, Ph.D., epidemiologist, University of Auckland, New Zealand; Amit Khera, M.D., professor, cardiology, UT Southwestern Medical Center, Dallas; Sept. 17, 2019,Annals of Internal Medicine, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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